Case in point

Some people — who shall go nameless for now — call some of us “privacy nuts” as if it’s a bad thing.

But anyone who works in the field of mental health, as I do, may be understandably seriously concerned about privacy and security issues.  I received a phone call this week that’s a case in point.  Since the caller is not a patient, I can talk about it.

The phone rings and I answer it.  It’s someone calling — not to seek therapy for himself — but he’s calling for a friend who may or may not call me, depending on my answers to a few questions.

The person who needs the therapy wants to know if the therapy can be anonymous.

I ask what the caller means and explain that if the concern is insurance companies finding out about health issues, the way around that is to pay cash and not submit any insurance claims.  A number of patients use that option when seeing mental health professionals, as there is still, unfortunately, a stigma associated with mental health problems.

Okay, he says, but do I actually have to know the patient’s real name?  Could I write a prescription without a name?

By now, I’m beginning to wonder about how serious the patient’s problem(s) might be, even though I haven’t been told any diagnoses.  I explain that first, I don’t write prescriptions as I’m  not a physician, second, I don’t know any legitimate physician who would write a prescription without knowing the patient’s name, and third, yes, I do need to know the patient’s identity but that my records remain in my office and are not shared with anyone — and that despite current trends, I avoid electronic records which reside on systems that could be hacked, etc.

The caller’s friend may be a somewhat extreme example, but there are people in need of mental health treatment who really are very worried about who might find out their diagnoses or other sensitive mental health data.    Could the caller have been sounding me out to see if they could get a drug prescription for a controlled substance for the wrong reasons?  Sure, but my impression was simply that the friend was highly anxious about anyone finding out their diagnosis or that they needed or would be getting treatment.

Forcing people to have records on systems than are inadequately secured or to which too many people might have access is going to scare them away from seeking help.    And since some people cannot afford treatment without using insurance benefits, we need to ensure that databases really are secure and that records really are kept confidential, etc.   Forcing providers to use systems that are not adequately secured from security or privacy breaches is just incompatible with our obligation to really keep sensitive information confidential.

So yes, you can call me a “privacy nut,” and I’ll wear the mantle proudly.

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